- University of Miami (Fort Lauderdale, FL)
- …insurance eligibility of patient coverage benefits, notifying patient and referring physician in the event of failed eligibility. + Collaborates with scheduling ... resource for lower-level Patient Services staff. Recommends new approaches to management for enhancing performance and productivity. + Deploys critical thinking… more
- CVS Health (Tallahassee, FL)
- …review, and appeal request. This position is primarily responsible for Utilization Management , including prior authorization and precertification as well ... part of a centralized team that supports the Medical Management staff and may support other health plans as...at Health Plan / Insurer or experience as a Physician Advisor or working for an Independent Review Organization… more
- Molina Healthcare (Orlando, FL)
- …years experience as a Molina Medical Director + Demonstrated experience in Utilization /Quality Program management + Previous leadership experience + Peer review, ... from government and accreditation regulators. + Directs the team in providing physician leadership and expertise in the performance of prior authorization, inpatient… more
- Sedgwick (Tallahassee, FL)
- …lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization ... college or university preferred. **Experience** Four (4) years of claims management experience or equivalent combination of education and experience required.… more
- Florida Health Care Plans, Inc. (Daytona Beach, FL)
- …Details * Evaluation, assessment, and treatment of Behavioral Health patients * Case Management functions * Utilization Management functions. * Special ... as a liaison * Develops and implements psychoeducational program. * Assist the Physician Director with tasks and policy and procedures of the Department. * Provides… more
- HCA Healthcare (Panama City, FL)
- …to established policies, procedures, and protocols. + Reviews and interprets all physician orders received, using the patient profile. Screens all medication for ... clinical pharmacy services toward patient outcomes and cost savings through the management of the clinical program. + Designs, implements, monitor and evaluate drug… more
- University of Miami (Miami, FL)
- …and flyers. + Prepares periodic reports, financial statements, and records for management or outside agencies. + Maintains patient confidentiality as well as the ... throughout their journey. + Facilitates virtual care offerings through schedule management , patient education/preparedness, and coordination of the virtual visits. +… more
- AdventHealth (Daytona Beach, FL)
- …etc.) Utilizes multiple avenues to obtain follow-up such as phone calls, physician offices, written communication, and other sources. + Maintains professional work ... **Minimum qualifications:** + Associate's degree in Healthcare or Health Information Management + Completion of education program and/or work experience required for… more
- AdventHealth (Daytona Beach, FL)
- …budgeting and support of the budget. Maintains staffing and scheduling, and resource utilization within budgeted targets for the unit. + Collaborates with peers and ... personnel throughout nursing departments + Fosters patient, family, staff, and physician satisfaction. Understands the impact of dissatisfaction on the business… more
- AdventHealth (Daytona Beach, FL)
- …and aim to increase quality, increase patient satisfaction and reduce unnecessary utilization of health care resources. AdventHealth Senior Care is creating a new ... related functions as appropriate for patient population. + Incorporates member, physician , customer needs and concerns into decision-making. + Demonstrate ability to… more